Changing trends in incidence and clinical spectrum of extra-pulmonary tuberculosis: a 10-year retrospective study in a rural teaching hospital in South India

Abstract

Background: EPTB, remains a great mimicker in spite of availability of new diagnostic tools. The data available in different literatures and national record remain inconclusive. This study aims to find the change in incidence and clinical spectrum of EPTB during 10 years in the proposed study center.Methods: Retrospective, medical records based study, on patients newly diagnosed to have EPTB, at MOSC-MCH, Kolenchery, Kerala, India from 1-01-2006 to 31-12-2015.Results: Among the 1488 new cases of tuberculosis 665 (44.7%) had EPTB and 823 (55.3%) had pulmonary TB (PTB). There was a consistent rise in annual number of new cases of EPTB from 2007 to 2013. Lymph-node, 31% (n=203) and pleural effusion 26% (n= 126) are common sites. There was female gender predominance in the age group of 18-44 years. Commonest site of lesion in females as well as in males was lymph node TB (n=121, 35.9% and n=82, 25% respectively). Pleural effusion and genital TB showed a male predominance.Conclusions: Incidence of EPTB shows an increasing trend from 2006 to 2015 in this study which is in contrast to the falling state and national trends. In the global TB reports, India has underestimated TB data between 2000 and 2015. The rising trend of new cases in our study centre can be the impact of immigrant labourers or may be due to increased referred cases to this tertiary centre. Further multicentre studies and studies among the immigrant labourers should be done to evaluate this.